Aortic intramural hematoma: Review of high-risk imaging features

Aortic intramural hematoma is among the spectrum of pathologies that comprises acute aortic syndrome and carries a risk of progression to aortic dissection, aneurysm, rupture, and other complications. Evaluation by CT can identify imaging features associated with higher risk of complications. Ulcer-like projections, enlarged aortic diameter, increased hematoma thickness, and Stanford type A classification are associated with progression to complications. The significance of intramural blood pools within the hematoma and associated pleural/pericardial effusions is less certain. Detailed evaluation of intramural hematoma with CT can provide critical prognostic information with implications for patient management.